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General NPI Number Information
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NPI Number | 1235118761
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Entity Type | Individual
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Provider Name | JOHN OZMENT REYNOLDS M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/12/2006
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Last Update Date | 03/16/2015
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Provider Practice Location Address
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Address Line | 530 CORPORATE CIRCLE
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City | SALISBURY
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State | NC
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Zip | 28147
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Country | US
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Telephone | 704-637-0158
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Fax | 704-637-7710
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Provider Business Mailing Address
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Address Line | 530 CORPORATE CIRCLE
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City | SALISBURY
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State | NC
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Zip | 28147
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Country | US
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Telephone | 704-637-0158
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Fax | 704-637-7710
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 17420
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 17420
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License Number State | NC
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